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<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
</head>

<body>
<div align="center">
  <h2>Customer Info  </h2>
  <h2 align="center">Add Customer information in the given fields .</h2>
</div>
<form action="added.php" method="post" >
  <table width="100%" border="0" cellspacing="5" cellpadding="5">
      <tr>
        <td colspan="2"><h2 align="center">Personal Info  </h2></td>
   	<tr>
        <td width="50%"><div align="right">Account No </div></td>
        <td width="50%"><label>
          <input type="text" name="accountnumber" id="accountnumber" />
        </label></td>
      </tr>
    <tr>
      <td width="525"><div align="right">First Name </div></td>
      <td width="528"><label>
        <input type="text" name="firstname" id="firstname" />
      </label></td>
    </tr>
    <tr>
      <td><div align="right">Last Name</div></td>
      <td><input name="lastname" type="text" id="lastname" maxlength="30" /></td>
    </tr>
    <tr>
      <td><div align="right">Address</div></td>
      <td><input type="text" name="address" id="address" /></td>
    </tr>
    <tr>
      <td><div align="right">Phone No</div></td>
      <td><input type="text" name="phone" id="phone" /></td>
    </tr>
    <tr>
      <td><div align="right">NIC </div></td>
      <td><input type="text" name="nic" id="nic" /></td>
    </tr>
    <tr>
      <td><div align="right">Item </div></td>
      <td><input type="text" name="item" id="item" /></td>
    </tr>
    <tr>
      <td colspan="2"><div align="center">
        <h2>Reference Detail</h2>
      </div></td>
    </tr>
    <tr>
      <td><div align="right">First Name</div></td>
      <td><input type="text" name="reffirstname" id="reffirstname" /></td>
    </tr>
    <tr>
      <td><div align="right">Last Name</div></td>
      <td><input type="text" name="reflastname" id="reflastname" /></td>
    </tr>
    <tr>
      <td><div align="right">Address</div></td>
      <td><input type="text" name="refaddress" id="refaddress" /></td>
    </tr>
    <tr>
      <td><div align="right">Phone No.</div></td>
      <td><input type="text" name="refphone" id="refphone" /></td>
    </tr>
    <tr>
      <td><div align="right">NIC </div></td>
      <td><input type="text" name="refnic" id="refnic" /></td>
    </tr>
    
  <td colspan="2"><div align="center">
        <h2>Account Information</h2>
      </div></td>
    <tr>
      <td width="525"><div align="right">Original Amount</div></td>
      <td width="528"><label>
        <input type="text" name="originalamount" id="originalamount" />
      </label></td>
    </tr>
    
    <tr>
      <td><div align="right">Profit Percentage       
      </div>        
        <label>
        <div align="right"></div>
      </label></td>
      <td><label>
         <select name="profit" id="profit">
          <option>5</option>
          <option>10</option>
          <option>15</option>
          <option>20</option>
          <option>25</option>
          <option>30</option>
          <option>35</option>
          <option>40</option>
          <option>45</option>
          <option>50</option>
          <option>55</option>
          <option>60</option>
          <option>65</option>
          <option>70</option>
                </select>
      </label></td>
    </tr>
    <tr>
      <td><div align="right">Tolal Amount</div></td>
      <td><label>
        <input type="text" name="totalamount" id="totalamount" />
      </label></td>
    </tr>
    <tr>
      <td><div align="right">Advance</div></td>
      <td><label>
        <input type="text" name="advance" id="advance" />
      </label></td>
    </tr>
    <tr>
      <td><div align="right">Remaining</div></td>
      <td><label>
        <input type="text" name="remaining" id="remaining" />
      </label></td>
    </tr>
    <tr>
      <td><div align="right">Installment / Month</div></td>
      <td><label>
        <input type="text" name="installmentpermonth" id="installmentpermonth" />
      </label></td>
    </tr>
    <tr>
      <td><label>
          <div align="right">
            <input type="submit" name="Submit2" id="Submit2" value="Add" />
          </div>
        <div align="right"></div>
        <div align="right"></div>
        </label></td>
    <td><label>
          <div align="left">
            <input type="reset" name="button" id="button2" value="Reset" />
          
          </div>
          
  </table>
        </label></td>
    </tr>
  <p>&nbsp;</p>
  <p><a href="manageCustomer.php">Back to Manage Customer Menu</a></p>
 
</form>
<p>&nbsp;</p>
</body>
</html>
